Stages of malignant breast cancer and the fastest treatment methods


Cancer is one of the most difficult experiences that a person may face in his life. The patient begins to wonder about the different treatment options and their duration, and whether she can return to her normal life after this experience. Therefore, a breast cancer patient always seeks to know the stage she is going through, as knowing this stage is very important in the course of treatment and providing reassurance. Doctors also rely on determining the stage of breast cancer to determine the most appropriate treatment for the case. Since the number of cases of this type of cancer reaches about two million cases annually worldwide, we see the importance of clarifying all information related to breast cancer through the "Dalili Medical" website through the upcoming series of articles.

**What is breast cancer?**

The word "cancer" refers to the growth of abnormal and malignant cells that do not perform any vital function in the body. These cells have the ability to move from their original location to invade other organs, causing damage to those tissues and losing their normal function. Therefore, "breast cancer" means the growth of malignant cells in breast tissue.

**What are the most dangerous types of breast cancer in women?**

Aggressive tumors are considered the most dangerous types of breast cancer, as they spread from their site of origin to affect other organs. There are also other dangerous types, such as inflammatory tumors.

**Is it possible to completely recover from breast cancer?**

Yes, it is possible to completely recover from breast cancer by removing malignant tumor cells and undergoing complementary treatment to increase the chances of recovery. It is important to know that early diagnosis of breast cancer, of all types, increases recovery rates, God willing.

**What is the difference between a self-breast examination and a breast examination in the clinic?**

A self-breast examination is one of the essential factors for early detection of breast cancer, and a woman should do it at least once a month starting at the age of twenty. However, if a woman has a positive family history of breast cancer or is in the risk group, she should undergo a medical examination by a specialist in the clinic once every three years until the age of forty, and then once a year after that. The specialist surgeon examines the breast and lymph nodes under the armpit at each visit to ensure that there are no lumps or changes.

**How ​​to prepare for a breast self-examination?**

A breast self-examination is an easy procedure, but to get the most out of it, it is recommended to:

1. Consult a doctor to understand how to perform a self-examination.

2. Choose the right time, as it is preferable to perform the examination several days after the end of menstruation, when the breast is less swollen and painful.

**How ​​to perform a breast self-examination?**

The self-examination is divided into two stages:

1. **Stage One: Visual Examination**

The woman begins by visually examining the breast in front of the mirror, noting any changes in size, shape or symmetry, in addition to looking for any traces of dimpling or wrinkling, and any changes in the direction of the nipple or secretions from it.

2. **Stage Two: Hand Examination**

You can lie on a flat surface before starting the manual examination, with a pillow under the shoulder on the examination side. The right breast is examined with the left hand, as the breast is divided into four areas and each area is examined separately, in addition to examining the nipple, the area under the breast and under the armpit.

**Does breast cancer spread quickly?**

Breast cancer spreads to other parts of the body, which is a major cause of death in 90% of cases. Therefore, it is natural for the patient to feel concerned about the speed of its spread and to want to start treatment quickly. It usually takes between 55 and 200 days for the cancer to grow to double, and this period varies depending on several factors that affect the growth rate of breast cancer.

**Cancer type:** In the case of inflammatory breast cancer, the growth rate is much faster compared to other types of breast cancer.

**Age at diagnosis:** When diagnosed at a young age, the growth is faster than breast cancer in older women.

**Menopausal status:** The incidence of breast cancer increases in the period before menopause compared to the period after it, due to changes in estrogen levels in the body.

**Estrogen therapy:** Women who receive hormone replacement therapy after menopause may experience a faster growth rate of breast tumors.

**Tumor grade:** The higher the grade of the tumor, the faster the disease spreads.

**What is the importance of early detection of breast cancer?**
- 98% of cases that are detected in their early stages can be treated and completely cured.

- 80% of breast tumors are benign and non-cancerous.

- 80% of breast cancer tumors are discovered by women themselves during self-examination.

- There are 2.4 million breast cancer survivors in the United States today.

**What are the ages most at risk for breast cancer?**

Risk factors for breast cancer vary from person to person, but age is one of the most important factors. The risk increases with age, as 80% of women diagnosed with breast cancer are over the age of 45. Women between the ages of 50 and 74 are advised to undergo regular examinations, while women between the ages of 40 and 49, especially those who are considered at higher risk, should consult their doctor about the risks and benefits of regular examination.

**What is a breast cancer self-examination?**

A breast self-examination is one of the most important ways to detect breast cancer early, as it facilitates treatment if it is detected early. A self-examination should be performed once a month, and includes several steps that must be followed:

1. **Self-examination using a mirror:**

- Stand in front of a mirror in a well-lit room, and examine your breasts to make sure there is no difference in shape or size.

- Check your nipples and notice any changes such as peeling or change in direction.

- Place your hands on your hips and tighten your gluteal muscles.

Chest, then examine your breasts.

- Raise your hands above your head and repeat the examination.

- Press the area around your nipple and check for discharge.

**Breast self-examination while showering**

You can perform a breast self-examination while showering by following these steps: Make sure there are no changes in your breast. Having soap and water on your hands will help you glide your hands more smoothly. Check your armpit area for any lumps or thickening in the tissue. Raise your hands above your head and check for any lumps by pressing your breast.

**Breast self-examination while lying on your back**

You can perform a breast self-examination while lying down by using your right hand to pass it over your left breast in circular motions, while raising your left hand behind your head. Moisturizing cream can be used to make the movement easier.

**Types of Breast Cancer**

There are several types of breast cancer, which are divided into two main groups as follows:

1. **Invasive breast cancer**: This type is characterized by the spread of cancer cells to other parts of the breast or to distant parts of the body, and is divided into two types:
- **Invasive ductal carcinoma**: It is the most common and originates from the mammary ducts.
- **Invasive lobular carcinoma**: It is the second most common type and originates from the mammary glands.

2. **Non-invasive breast cancer**: This type is characterized by the cancer cells remaining in a specific place in the breast without invading the surrounding tissues or spreading to other parts of the body, and is divided into two types:
- **Ductal carcinoma in situ**: It develops from the milk ducts and does not invade the surrounding tissues.
- **Lobular carcinoma in situ**: It develops from the mammary glands, and is a non-invasive type.

**Rare types of breast cancer include:**
- **Inflammatory breast cancer**: A rare and aggressive type in which cancer cells block the lymphatic vessels in the skin, causing breast swelling and symptoms similar to signs of inflammation.
- **Paget's disease of the breast**: Develops in the ducts of the nipple and affects the skin of the nipple and the surrounding areola.
- **Phylloid tumor**: Grows in the connective tissue of the breast. These tumors are usually benign, but some may be cancerous.
- **Angiosarcoma**: Grows in the blood vessels or lymphatic vessels in the breast.

**How ​​are breast cancer stages determined?**

Determining the stage of breast cancer depends on a set of tests performed by the doctor, starting with a physical examination, then imaging tests such as mammograms and blood tests, and ending with an analysis of a biopsy of breast tissue under a microscope. After the results of these tests appear, the stages of breast cancer are determined based on the following factors:
- The size of the tumor.
- The extent and number of the tumor has spread to nearby lymph nodes.
- The extent of the tumor's spread into tissues close to the breast, such as the skin or chest muscles.
- The spread of the tumor to distant lymph nodes or other parts of the body, such as the lungs or liver.
- The tumor contains hormone receptors, such as progesterone and estrogen receptors.
- The tumor produces a protein called HER2.
- The degree of cancer and the extent to which cancer cells resemble normal cells.

**The importance of determining breast cancer stages**

Knowing the stages of breast cancer is of great importance in several aspects, including:

1. **Determining appropriate treatment options**: Determining the stage helps in choosing the best treatments that are compatible with the characteristics of the cancer and the extent of its spread.

2. **Predicting the course of the disease**: By knowing the stage, doctors can predict the development of the disease and the results of treatment.

3. **Estimating the chances of survival**: The earlier breast cancer is detected, the greater the chances of recovery.

**Breast Cancer Stages**

Breast cancer is divided into five stages, expressed by numbers from zero to four, and Roman numerals (I, II, III, IV) are often used for stages 1 to 4. The higher the number, the more severe the disease. The stages of breast cancer development include:

- **Stage 0**: Also known as carcinoma in situ (CIS), the abnormal cells remain where they originated without invading nearby healthy tissue. There are often no symptoms at this stage, and there may not be a tumor mass that can be felt, making it difficult to detect, but a routine mammogram can detect it. There are two types of breast cancer at this stage:

- Ductal Carcinoma In Situ (DCIS).

- Lobular Carcinoma In Situ (LCIS).

Treatment at this stage may include removing the mass if present, or radiation or hormone therapy.

- **Stage I**: Stage I is considered an early stage of invasive breast cancer, where cancer cells have spread to nearby tissues within the breast. The tumor at this stage is 2 cm or less in size, which can make it difficult to detect. This stage is divided into two categories:
- **Stage I A**: Where the tumor is 2 cm or less in size, without cancer cells spreading to nearby lymph nodes.
- **Stage I B**: There may be no lump in the breast or it may be smaller than 2 cm, with small cancer cells in some nearby lymph nodes.

Symptoms at this stage include feeling an abnormal lump in the breast, which is usually hard and painless. The cure rate is high at this stage when diagnosed early, and treatment methods include removing the tumor and affected lymph nodes, and in some cases removing the entire breast, in addition to radiation, chemotherapy and hormone therapy to reduce the chances of the cancer returning.

- **Stage II**: This stage indicates that the tumor has increased in size or has spread to nearby lymph nodes, without extending to distant parts of the body. Breast cancer at this stage can usually be detected through self-examination, where the patient feels a hard lump in the breast or under the armpit, and may have nipple discharge or changes in the skin of the breast. This stage is divided into 

Two categories:
- **Stage IIA**: includes no tumor in the breast with cancer cells spreading to 1-3 lymph nodes in the armpit, or a tumor 2 cm or smaller with spread to 1-3 lymph nodes, or a tumor 2-5 cm without spreading to the lymph nodes.

**Stage II Breast Cancer**

Stage II breast cancer includes the following cases:
- A breast tumor ranging in size from 2 to 5 cm with cancer spreading to 1 to 3 axillary lymph nodes.
- A breast tumor larger than 5 cm, without cancer spreading to the axillary lymph nodes.

Treatment at this stage may include removing the tumor or the entire breast, in addition to the possibility of undergoing radiation therapy. Chemotherapy may be used before surgery to shrink the tumor, or after surgery to get rid of any remaining cancer cells, while hormone therapy is used in some types of breast cancer. The survival rate for stage 2A is slightly higher than for stage 2B, however, the chances of survival for all women with stage 2 breast cancer are high, especially if diagnosed early.

**Stage III Breast Cancer**

Stage III breast cancer is known as locally advanced breast cancer, where the tumor may be larger than 5 cm. This stage is considered advanced, as the cancer cells have spread to several nearby lymph nodes, and may extend to the skin or chest wall, but have not yet spread to distant organs in the body.

Stage III is divided into three categories:
- **Stage IIIA**: Where the tumor is larger than 5 cm in size and the cancer has spread to between 1 and 3 lymph nodes, or there is no mass in the breast and the cancer has spread to between 4 and 9 nearby lymph nodes.
- **Stage IIIB**: Where the tumor has spread outside the breast to the skin or chest area, and may have spread to several nearby lymph nodes.
- **Stage IIIC**: The cancer has spread to 10 or more lymph nodes, including the nodes near the collarbone.

Treatment of breast cancer in stage III is more complex than in the early stages, and treatment usually includes chemotherapy to shrink the tumor, followed by surgery, then radiation or hormonal therapy.

**Stage IV Breast Cancer**

Stage IV breast cancer is known as advanced or metastatic breast cancer, and it is the final stage where cancer cells have spread to different parts of the body such as the bones, lungs, liver, or brain. The tumor at this stage may be of different sizes, and this stage is considered the most dangerous in breast cancer, as it threatens the patient's life.

Treatment at this stage is difficult, and its goal is to relieve symptoms and limit the spread of cancer. Treatment methods used in the advanced stage include:
- Chemotherapy.
- Hormonal therapy.
- Radiation therapy, often used for brain tumors.
- Surgery, but rarely used at this advanced stage.

**What are the symptoms of breast cancer?**

In the early stages of breast cancer, there may be no obvious symptoms, but some cancerous lumps can be detected through a mammogram. Usually, the first symptom noticed is the appearance of a new lump in the breast that was not previously present. It is important to note that not every lump means cancer, as it may be benign or malignant. Symptoms may also vary from person to person. Possible symptoms of breast cancer include:

- The appearance of a lump in the breast or an increase in tissue thickness, as this lump is new and looks different from the surrounding tissue.
- Persistent breast pain or a constant burning sensation in the nipple.
- A change in the color of the breast to red or the appearance of dimpling in the breast.
- Swelling of the entire breast or parts of it.
- Discharge from the nipple, which may be clear or milky white or bloody.
- Peeling of the skin of the nipple or the entire breast skin.
- A sudden change in the shape or size of the breast.
- Inversion of the nipple (inverted or sunken nipple).
- Lumps and swelling in the armpit area, indicating swollen lymph nodes.

**Who are the women most at risk of developing breast cancer?**

There are many risk factors associated with breast cancer, but the presence of these factors does not necessarily mean that you will develop the disease. Among the risk factors are:

- A previous history of breast cancer.
- Age, as the risk increases with age.
- A first-degree family member (mother, sister, or daughter) has had breast cancer.
- A male in the family has had breast cancer.
- The presence of the breast cancer gene in the DNA.
- A previous breast biopsy.
- Pregnancy and childbirth for the first time after the age of 35 or not having children.
- Starting menstruation at an early age (before 12 years) or the onset of menopause late (after 55 years).
- Excess weight.
- Continuous exposure to radiation.
- Alcohol consumption.
- Hormone replacement therapy.

**How ​​can early breast cancer screening help reduce its risks?**

Health authorities recommend that women aged 20 to 34 years undergo early breast cancer screening according to the following steps:
- Perform a monthly breast self-examination.
- Visit a doctor for a clinical examination every two years.

As for women aged 35 years and older, it is recommended to perform early breast cancer screening as follows:
- Continue to perform a monthly breast self-examination.
- Perform a clinical examination with a doctor annually.
- Perform a mammogram once at the age of 35, then every year or two between the ages of 40 and 49.

For women aged 50 years and older, it is recommended to perform early breast cancer screening as follows:
- Perform a monthly breast self-examination.
- Perform a clinical examination with a doctor annually.
- Perform a mammogram annually.

It is important for any woman who experiences symptoms or problems with 

Breast cancer patients should be referred to a specialist immediately, regardless of their age.

**Risk factors for breast cancer**

A risk factor is anything that increases the likelihood of developing a certain disease, such as cancer. However, it should be noted that having one or more risk factors does not necessarily mean that a person will develop the disease. Some risk factors for breast cancer, such as family history and advanced age, cannot be changed. However, there are risk factors that can be controlled to significantly reduce the likelihood of developing breast cancer.

Some risk factors are related to women's reproductive history, the most prominent of which are:
- Women who had their first child at a late age or never had children.
- Women who started their menstrual cycle at an early age (less than 12 years) or stopped their cycle at a late age (after 55 years).
- Women who take certain types of hormone replacement therapy during menopause.
- Women who have received radiation therapy to the chest area.
- Women who are obese during menopause.
- Women who have had a previous breast biopsy or who have certain changes in their breast cells.

**Breast Cancer Treatment Methods**

Surgery is one of the most prominent treatment options available for treating breast cancer, whether in its early stages or locally advanced. The types of breast cancer surgeries vary, and the doctor determines the most appropriate option based on several factors, including the size of the tumor, its spread, and the type of cancer. Surgical treatment may also include removing some of the lymph nodes to which the cancer has spread.

Surgical methods for treating breast cancer include the following:

1. **Lumpectomy**: In this procedure known as "lumpectomy", the cancerous mass is removed along with a small portion of the surrounding healthy tissue, which helps preserve most of the breast tissue. This procedure is also called "breast-conserving surgery" or partial mastectomy.

2. **Total mastectomy**: In some cases, the best option is to remove the entire breast (mastectomy). There are several types of mastectomy, and the doctor may then perform breast reconstruction surgery to restore the normal shape of the breast using an implant or natural tissue taken from another part of the body.

3. **Axillary lymph node removal**: Cancer cells can spread to the axillary lymph nodes, in which case they are removed through the following procedures:
- **Sentinel Node Biopsy**: This involves taking a biopsy from the sentinel lymph node, which is the first node to which breast cancer can spread. If no cancer cells are found in this node, there is no need to remove other lymph nodes.
- **Axillary Lymph Node Dissection**: In this procedure, a number of lymph nodes in the armpit area are removed if cancer cells are found in the sentinel node, with the aim of preventing the spread of cancer.

**Radiation therapy**: Radiation therapy is used to treat breast cancer by directing high doses of radiation to kill cancer cells. This treatment is usually given after surgery, but in some cases it may be given before.

- **Neoadjuvant Radiation Therapy**: This is used to shrink a large tumor before surgery.
- **Adjuvant Radiation Therapy**: This is the most common, and aims to eliminate any cancer cells remaining after surgery. It usually starts about a month after surgery or chemotherapy, and is given in several sessions that extend from 3 to 5 days a week, and the treatment period lasts from 3 to 6 weeks.

**Chemotherapy**: This is one of the methods of treating breast cancer, as it involves the use of drugs that aim to destroy cancer cells or prevent them from growing and dividing. Chemotherapy can be given before or after surgery:

- **Neoadjuvant Chemotherapy**: This aims to shrink the tumor to make it easier to remove.
- **Adjuvant Chemotherapy**: It works to destroy any remaining cancer cells and reduces the likelihood of cancer returning.

Chemotherapy is also used in cases of breast cancer that has spread to the lungs, bones, liver, or anywhere else in the body, especially when the cancer reaches stage four.

The doctor determines the appropriate medication for each case, and treatment may include a combination of medications together. Chemotherapy is taken either in the form of tablets or through an intravenous infusion, and is given in several cycles, where the dose is given once every two to four weeks. The period of chemotherapy for breast cancer usually lasts from about 3 to 6 months.

As for hormonal therapy for breast cancer, this type of treatment is used in cases of hormone receptor-positive breast cancer, which is a type of cancer that is affected by the growth of estrogen or progesterone hormones naturally present in the body. Hormonal therapy aims to reduce the levels of estrogen and progesterone hormones and prevent their effect on cancer cells, which helps stop the activation of cancer growth. Hormone therapy includes several types of medications, such as:

- Medications that prevent female hormones from binding to their receptors on cancer cells, such as tamoxifen.
- Medications that destroy hormone receptors on cancer cells, such as fulvestrant.
- Medications that inhibit the production of estrogen and progesterone in the body, such as aromatase inhibitors. In some cases, the doctor may recommend removing the ovaries to reduce the levels of female hormones.

Choosing the appropriate type of hormone therapy depends on several factors, such as the degree of cancer, age, and menopause 

 

Hormone therapy is used for several purposes, including:

- Reducing the size of the tumor before surgery.

- Reducing the risk of breast cancer recurrence after surgery.

Hormone therapy can be used alone in some cases where chemotherapy, surgery, or radiation treatments are not suitable. The period of hormone therapy before surgery may last from 3 to 6 months, while it can continue after surgery for a long period of up to more than 5 years.

As for targeted therapy for breast cancer, it works to target specific genes or proteins in cancer cells that contribute to the growth and continuation of the tumor, with the aim of preventing the growth and spread of cancer cells, while reducing damage to healthy cells. Targeted therapy is used to treat some types of breast cancer, such as HER2-positive breast cancer, and the drug Trastuzumab is one of the most famous targeted therapies. Targeted therapy is given in the form of tablets, injections, or intravenous infusion.

As for immunotherapy for breast cancer, also known as biological therapy, it aims to enhance the body's defenses and natural immunity to fight cancer cells. An example of immunotherapy for breast cancer is pembrolizumab. Immunotherapy can be used in the following cases:

- Treatment of triple-negative breast cancer.
- Treatment of invasive breast cancer in the second stage.
- Treatment of metastatic breast cancer.

ماذا نعني بسرطان الثدي؟ما هي أخطر أنواع سرطان الثدي عند النساء؟هل يمكن الشفاء تمامًا من سرطان الثدي؟ما الفرق بين الفحص الذاتي للثدي و فحص الثدي في العيادة ؟كيف يتم التحضير للفحص الذاتي للثدي ؟ينقسم الفحص الذاتي للثدي إلى مرحلتين أساسيتين : المرحلة الأولى الفحص البصري ثم الفحص باليدين :مراحل الفحص الذاتي للثدي هل ينتشر سرطان الثدي بسرعة؟ما هي أهمية الكشف المبكر عن سرطان الثدي ؟ما هي الاعمار الاكثر عرضة للإصابة بسرطان الثدي؟ما هو الفحص الذاتي لسرطان الثدي؟الفحص الذاتي للثدي بواسطة المرآةالفحص الذاتي للثدي أثناء الاستحمامأنواع سرطان الثديكيف يتم تحديد مراحل سرطان الثدي؟أهمية تحديد مرحلة سرطان الثديينقسم سرطان الثدي المرحلة الأولى إلى فئتين: ما هي اعراض سرطان الثدي؟من هن النساء الاكثر عرضة للاصابة بسرطان الثدي؟كيف يمكن ان يحمي الفحص المبكر لسرطان الثدي من مخاطره؟عوامل الخطر للإصابة بسرطان الثديكيفية علاج سرطان الثدي